ATI RN
ATI RN Mental Health Asn Questions
Extract:
Question 1 of 5
A nurse notices that a client who has moderate anxiety is pacing the hall and mumbling. As the nurse approaches the client, he states, 'I am at the end of my rope. I don't think I can take any more bad news.' Which of the following responses should the nurse make?
Correct Answer: B
Rationale:
Correct
Answer: B. "Come with me to an area where we can talk without interruption."
Rationale: By inviting the client to a private area for a conversation, the nurse demonstrates empathy, active listening, and a willingness to provide support. This response acknowledges the client's distress and creates a safe space for the client to express their feelings and concerns openly. It also allows the nurse to assess the client's current state and provide appropriate interventions or referrals. This approach promotes therapeutic communication and helps establish trust between the client and the nurse.
Summary of other choices:
A: Incorrect. Lying down may not be suitable for a client experiencing moderate anxiety and distress.
C: Incorrect. While relaxation exercises can be beneficial, they may not be the immediate priority in this situation.
D: Incorrect. Offering medication as the first response without further assessment or therapeutic communication is not ideal and may not address the client's underlying concerns effectively.
Question 2 of 5
A nurse is caring for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?
Correct Answer: B
Rationale: The correct answer is B: Identify precipitating factors for ritualistic behaviors. This is the first action the nurse should take because understanding the triggers for the client's ritualistic behaviors is essential in developing an effective care plan. By identifying these factors, the nurse can work with the client to address them and potentially reduce the frequency or intensity of the OCD symptoms. Discussing coping strategies (choice
A), teaching relaxation techniques (choice
C), and providing a structured activity schedule (choice
D) are important interventions but should come after identifying the triggers to ensure they are tailored to the individual's specific needs.
Question 3 of 5
A nurse is assessing a client who is experiencing chronic stress. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Viral infection. Chronic stress weakens the immune system, making the individual more susceptible to infections like viral illnesses. This is due to the prolonged release of stress hormones, which suppress immune function. Hypotension (
A) is unlikely as stress typically raises blood pressure. Increased energy (
C) is less likely as chronic stress often leads to fatigue. Increased cognitive awareness (
D) is not a common finding with chronic stress, as it can impair cognitive function.
Question 4 of 5
A nurse in a drug and alcohol detoxification center is planning care for a client who has alcohol use disorder. Which of the following interventions should the nurse identify as the priority?
Correct Answer: B
Rationale: The correct answer is B: Providing for adequate hydration and rest. The priority in caring for a client with alcohol use disorder is addressing physical needs like hydration and rest to manage withdrawal symptoms and prevent complications. Hydration helps prevent dehydration and electrolyte imbalances, while rest supports the body's healing process.
Choices A, C, and D focus on psychological aspects, which are important but secondary to addressing immediate physical needs. Helping the client identify positive traits can come later in therapy, confronting denial and defense mechanisms can be addressed once the client is stabilized, and educating about consequences is important but not as urgent as ensuring hydration and rest.
Question 5 of 5
A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors?
Correct Answer: C
Rationale: The correct answer is C: Plan the client's schedule to allow time for rituals. This is the most appropriate action as it acknowledges the client's need for engaging in compulsive behaviors while also structuring the time effectively. Isolating the client (
Choice
A) would be counterproductive, as social isolation can exacerbate OCD symptoms. Confronting the client (
Choice
B) may lead to increased anxiety and resistance. Setting strict limits (
Choice
D) can cause distress and potential non-compliance. The key is to support the client by incorporating their rituals into the schedule while working towards gradually reducing them in a therapeutic manner.